Vaginismus, the unconscious tightening of the vaginal muscles, is unpleasant, to say the least. Now classified as Genito-Pelvic Pain Penetration Disorder (GPPPD), this sexual dysfunction makes penetrative sex unpleasant, challenging, or downright impossible. With a prevalence rate of 15% (approximately 19 million U.S. women), it’s important to know some of the common causes. Additionally, although seeing a gynecologist is necessary for an official diagnosis, knowing if you experience some of the causes of vaginismus can give you information to bring to your doctor.
Before we begin, let’s take a moment to talk about the different terms surrounding this. The DSM-V incorporated past, female sexual dysfunctions into one broad category: Genito-Pelvic Pain Penetration Disorder. Though this is the current, diagnostic terminology, it can be vague on which specific sexual difficulty one is referring to. In this article, we will be discussing vaginismus: the unconscious tightening of the vaginal muscles that’s due to psychology, not biology. Though “GPPPD” is the official term for what we’re discussing, we will use “vaginismus” out of clarity.
A very common cause of vaginismus involves sexual trauma. For the purpose of clarity, we’re going to divide sexual trauma into two categories: sexual experiences with consent, and sexual experiences without. Regarding the latter, researchers Cherner and Reissing (2013) argue that sexual assault can uproot a person’s view of the world and sense of safety. Even though the next time they have sex could be in a safe environment, the sexual setting itself could be a reminder of the assault, causing the person to unconsciously tense up or tighten. Though survivors of sexual assault may feel ready to re-engage in sex, their bodies may highlight their unconscious inability to.
Sexual trauma can occur in consensual relationships, too. A woman could be in a loving, secure relationship with her partner, and still, have a negative or traumatic sexual experience. Maybe things went too fast and there wasn’t time for adequate lubrication, or perhaps the couple wanted to try something new and it ended painfully. There are numerous ways to have a bad sexual experience, and sometimes those experiences can even be traumatic.
For instance, after much thought, “Veronica” may decide to lose her virginity with her boyfriend. The night finally comes and both are uncomfortable and fairly tense. Instead of taking time to relax and let vaginal lubrication naturally occur, Veronica’s boyfriend thrusts immediately and powerfully. This causes Veronica a lot of pain, but because Veronica is unsure on how sex is supposed to feel, she assumes that the pain is normal. During her next sexual encounter, Veronica’s body unconsciously associates pain with sex, causing her body to tense up in anticipation. After having a traumatic experience with sex, a woman can unconsciously anticipate the next experience to be horrible, causing her tense up during the actual act of sex. This increased anxiety only serves to make sex more unpleasant, which then creates a vicious cycle.
Another common cause of vaginismus is the external messages that we hear about sexuality, especially female sexuality. Despite seeing sex in movies, tv shows, and billboards; the United States still has several hang-ups concerning sexuality. For example, many schools still teach abstinence-only sexual education. Having open conversations about sexual desire is still stigmatized, especially for women. They often face a double-standard where they are expected to be virginal and chaste, where men are expected to have tons of sexual experience. This is also present in certain religions.
In some religion, purity is often paired with a person’s chastity. For instance, think about the “good Christian woman”. No matter your religious affiliation or experience, you could probably imagine the woman as being virginal and only having sex after marriage. These social and religious messages often tell girls and women that they shouldn’t engage in sexual activities, that they’re bad if they do. Naturally, some women aren’t going to feel comfortable doing something that they’re “not supposed to do”, which can result in dysfunctions like vaginismus.
Whether they’re social or religious, these messages tend to make their way into the bedroom. Though a woman can consciously and consensually decide to have sex with someone, she can still hold a significant amount of guilt and even shame with doing it. Suddenly, she’s actively doing something that society and/or religion is telling her not to do. That guilt and shame can be hard to ignore, causing the woman to be more critical of herself. Her body then reacts to this discomfort, often resulting in vaginal tightness. Once again, sex is supposed to be relaxed and releasing. Stressful messages act in opposition to that, causing the woman to tense her muscles, not relax them. As strange as it might sound, it’s similar to putting in contacts.
If you’ve ever worn contacts before, try to remember your first time putting them in. In order to put in contacts, you have to be relaxed and calm. You have to trust that inserting this foreign object isn’t going to do you harm. Without that assurance, you tense up, stress out, and become frustrated that it’s taking so long to get the contacts in. The experience is very similar to vaginismus. Your body reacts to your anxiety, which makes the whole process of inserting something foreign into your body all the more difficult. Stressful thoughts make you stressed. Besides internalized messages, there are other common causes of vaginismus.
Sexual dysfunctions don’t always occur right away. Another cause of vaginismus is simply getting older. As women age, their levels of estrogen and progesterone decrease. This is especially the case following menopause. Estrogen and progesterone help lubricate the vagina during sexual arousal. Therefore, when these hormones decrease, so does the ease of pain-free penetration. In other words, more work, such as foreplay, is required to keep sex enjoyable. Without the work, the woman is more susceptible to pain. Pain can lead to fear, which can lead to bodily tension, which can lead to more pain. This can technically happen at any age; however, menopausal women are simply more at risk due to biology.
Vaginismus, or Genito-Pelvic Pain Penetration Disorder, is a sexual dysfunction that affects millions of U.S. women. About 1 out of 7 women have vaginismus, which makes its common causes important to know, especially if you suspect that you might have it. Though you cannot diagnose yourself, knowing if you share some of the common causes of vaginismus would be great information to bring to your gynecologist. Remember, millions of women experience this diagnosis; you are not alone with this. Plus, because vaginismus isn’t biological, it doesn’t have to be permanent. You have the power to deal with this diagnosis, and you have already taken the first, most essential step by reading this article. If you’re ready to take the next step, call your gynecologist. If you need additional support in taking the next step, help is available. Call us: 267-324-9564.